For centuries, management of freshwater resources has focused on monitoring and managing water quantity to ensure supplies for domestic, agricultural, and industrial use and to mitigate the potential effects of floods and droughts. However, the quantity of water is inextricably linked to its quality, yet much less attention has been paid to the latter. Every human use of water, and the aquatic ecosystem itself, has minimum requirements for water quality. At a national scale, managing water quantity and water quality have often been the remit of different government agencies with limited sharing of information. This report summarizes key aspects and presents a framework to assist water accounting teams to evaluate the needs for incorporating water quality monitoring into their operations. The framework presented in this report introduces a step-by-step approach to defining scope and objectives and to identifying data needs and monitoring approaches for data collection and computation of loads. Data analysis and presentation options are also explored. Implementation of the framework is illustrated with three different scenarios of different scope and scale of water accounting activities: an irrigation scheme, a river basin, and a reservoir. The scenarios illustrate suggested locations for monitoring, relevant water quality parameters for inclusion, the time frame for data collection, and interpretation of the results.